August 2, 2006 12:53 PM
Doctors say cardinal's cancer had not spread beyond bladder, ureters
By Michelle Martin
Catholic News Service
MAYWOOD, Ill. (CNS) -- Doctors at Loyola University Medical Center announced July 31 that the cancer in Chicago Cardinal Francis E. George's bladder and ureters had not spread.
Jesuit Father Myles Sheehan, who is Cardinal George's personal physician, opened the press conference by saying, "Given what we knew entering into the cardinal's surgery on Thursday, we are happy to report the best possible outcome. The tumor was contained within the bladder and ureters without evidence of going into the lymph nodes or metastasizing."
The cardinal should be able to resume his duties in several weeks, he said. He was moved from intensive care to a general medical/surgical floor the afternoon of July 31, and his doctors said he can expect to return home in about a week.
Cardinal George, 69, underwent a five-hour operation to remove his bladder, prostate gland and sections of his ureters -- the tubes that carry urine from the kidneys to the bladder -- the morning of July 27 at the medical center in Maywood. Just before midnight that night, he went back into surgery after his blood pressure became unstable; doctors found a small bleeding artery and closed it off.
Shortly after finishing the first operation, Cardinal George's medical team addressed journalists to explain that they had removed part of the blocked ureter and Cardinal George's prostate gland as well as his bladder.
The pathology report -- delivered to the cardinal at various times by Father Sheehan, Dr. Robert Flanigan, who performed the surgery, and Dr. Eva Wojcik, a pathologist -- showed a small, incidental cancer in his prostate gland, which happens about a third of the time when a man has his prostate removed as part of bladder cancer surgery. The small tumor was "incidental," Father Sheehan said, and not related to the bladder cancer.
The report also showed an invasive tumor in the muscle wall of the bladder, where the right ureter penetrated the wall and opened into the bladder. That tumor had not spread beyond the bladder wall, and no cancer was present in any of the lymph nodes.
In addition, a superficial cancer called "carcinoma in situ" had affected much of the interior of the bladder and the lower ends of both ureters, Sheehan said.
Flanigan put the five-year prognosis for recovery at Cardinal George's stage of cancer at 70 to 80 percent.
"We do not know absolutely that the cardinal is cured," Father Sheehan said. "We can say the cardinal is a cancer survivor with a good prognosis and there is no evidence of any cancer within his body."
He said Cardinal George will not need any radiation or chemotherapy as follow-up, and once he finishes recuperating, he should be able to return to his full duties as archbishop of Chicago.
"I hope he will be not quite so vigorous with his schedule, but I've felt that a long time," Father Sheehan said.
Indeed, the cardinal had already been reviewing some archdiocesan matters with the vicar general, Father John Canary, and will likely assume some limited duties around Labor Day, Father Sheehan said.
In the meantime, he was up and walked with the help of a walker July 31, and will begin physical therapy to regain strength, especially in his lower leg, which was weakened by a childhood bout with polio.
Father Sheehan said there still could be complications.
"It's like in the 'Wizard of Oz,'" he said. "There's a straight path through the forest, but there are lions and tigers and bears in the forest."
Also on July 31, the cardinal was allowed to begin eating again, "starting with a delicious clear liquid diet."
Colleen Dolan, the archdiocesan director of communications, reported that the cardinal had been reading his menu and was relieved to see he could still have some of his favorite foods -- chocolate, peanut butter, pasta and ice cream among them.
"He's really had his sense of humor throughout all of this," she said. "He has a very dry wit."
Following the release of the pathology report, Flanigan said the cardinal had authorized him to discuss the method doctors used to divert the urine coming from his kidneys. Essentially, he said, they used a section of bowel to create a new bladder that was attached to the ureters coming from his kidneys and to the urethra, which means the cardinal should be able to urinate normally.
Father Sheehan said the cardinal first called him to report seeing blood in his urine June 8. After preliminary tests, doctors looked into his bladder with a scope and found "atypical cells." Biopsies and CT scans July 14 showed that the cancer was "carcinoma in situ," a superficial but high-grade form of cancer. They also showed that the right ureter was partially blocked by the cancer.
That led to the decision to remove the entire bladder rather than trying to eradicate the cancer cells while leaving the bladder intact.
